Biodistribution of the 18F-FPPRGD2 PET radiopharmaceutical in cancer patients: an atlas of SUV measurements

  • Ryogo Minamimoto
  • Mehran Jamali
  • Amir Barkhodari
  • Camila Mosci
  • Erik Mittra
  • Bin Shen
  • Frederick Chin
  • Sanjiv Sam Gambhir
  • Andrei IagaruEmail author
Original Article



The aim of this study was to investigate the biodistribution of 2-fluoropropionyl-labeled PEGylated dimeric arginine-glycine-aspartic acid (RGD) peptide (PEG3-E[c{RGDyk}]2) (18F-FPPRGD2) in cancer patients and to compare its uptake in malignant lesions with 18F-FDG uptake.


A total of 35 patients (11 men, 24 women, mean age 52.1 ± 10.8 years) were enrolled prospectively and had 18F-FPPRGD2 PET/CT prior to treatment. Maximum standardized uptake values (SUVmax) and mean SUV (SUVmean) were measured in 23 normal tissues in each patient, as well as in known or suspected cancer lesions. Differences between 18F-FPPRGD2 uptake and 18F-FDG uptake were also evaluated in 28 of the 35 patients.


Areas of high 18F-FPPRGD2 accumulation (SUVmax range 8.9 – 94.4, SUVmean range 7.1 – 64.4) included the bladder and kidneys. Moderate uptake (SUVmax range 2.1 – 6.3, SUVmean range 1.1 – 4.5) was found in the choroid plexus, salivary glands, thyroid, liver, spleen, pancreas, small bowel and skeleton. Compared with 18F-FDG, 18F-FPPRGD2 showed higher tumor-to-background ratio in brain lesions (13.4 ± 8.5 vs. 1.1 ± 0.5, P < 0.001), but no significant difference in body lesions (3.2 ± 1.9 vs. 4.4 ± 4.2, P = 0.10). There was no significant correlation between the uptake values (SUVmax and SUVmean) for 18F FPPRGD2 and those for 18F-FDG.


The biodistribution of 18F-FPPRGD2 in cancer patients is similar to that of other RGD dimer peptides and it is suitable for clinical use. The lack of significant correlation between 18F-FPPRGD2 and 18F-FDG uptake confirms that the information provided by each PET tracer is different.


18F-FPPRGD2 PET/CT αvβ3 integrin expression Angiogenesis PET/CT Atlas 



We thank our research coordinators, the radiochemistry staff, and the nuclear medicine technologists. Special thank you to all the patients who agreed to participate in the study and their families.

Compliance with ethical standards


This study was partially funded by the Ben and Catherine Ivy Foundation and the Stanford Cancer Institute.

Conflicts of interest

S.S.G. Activities related to the present article: none to disclose. Activities not related to the present article: is on the board of Endra, Enlight, ImaginAB, MagArray, SiteOne Therapeutics, VisualSonics/Sonosite, and Click Diagnostics; is a consultant for VisualSonics/Sonosite, Gamma Medica, BMEB, and Bracco; received grants from General Electric and Sanofi-Aventis; received honoraria from ImaginAB; holds stock in Enlight and VisualSonics/Sonosite; received compensation for travel and accommodation from Gamma Camera.

A.I. Activities related to the present article: none to disclose. Activities not related to the present article: received grants from GE Healthcare and Bayer Healthcare.

R.M., M.J., A.B..., C.M., E.M., B.S., and F.T.C. declare no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Research support

Ben and Catherine Ivy Foundation; Stanford Cancer Institute.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Ryogo Minamimoto
    • 1
    • 2
  • Mehran Jamali
    • 1
    • 2
  • Amir Barkhodari
    • 1
  • Camila Mosci
    • 1
  • Erik Mittra
    • 1
  • Bin Shen
    • 2
  • Frederick Chin
    • 2
  • Sanjiv Sam Gambhir
    • 1
    • 2
  • Andrei Iagaru
    • 1
    Email author
  1. 1.Division of Nuclear Medicine and Molecular Imaging, Department of RadiologyStanford University, StanfordStanfordUSA
  2. 2.Molecular Imaging Program at Stanford (MIPS), Department of RadiologyStanford UniversityStanfordUSA

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